HomeMy WebLinkAboutHABITAT FOR HUMANITY OF OC (3)City of Santa Ana ` 0 Clerk of the Council o•1
AGREEMENT TERMINATION FORM
Please complete this form in its entirety when the attached agreement and all
amendments (if any) are no longer in effect.
Note: If your agreement is grant related, please ensure that all grant retention requirements
have been satisfied prior to signing the termination form.
Is the agreement(s) a permanent record? Yes No
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with
COTC Office Use Only '
PNR CITY CLERK
' 21! '23 Ami-0:37
No.
A-2021-068-086 was completed on 3 - �- 7j and final payment has been made.
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(List all amendments. Use space below if needed)
Department: C
Phone/Ext.:
Signature:
Date: '21'Z3
c5agreementsVorms\farm-agreement termination form—goldenrod.doc
MAYOR
INSURANCE NOT ON FILE
Valede Amezcua
MAYOR PRO TEM
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Lopez
COUNCILME IBERS
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CLERK OF COUNCIL
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Phil Became
Johnathan Ryan Hernandez
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David Penaloza
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Thal Vlel Phan
Benjamin Vazquez
CITY OF SANTA ANA
COMMUNITY DEVELOPMENT AGENCY
20 Civic Center Plata a P.O. Box 198a
Santa Ana, California 92702
er-•MA(V� vnv`n Santa- aoa
( (AV) January 3, 2022
Habitat for Humanity of Orange County, Inc.
Attn: Sharon Ellis, CEO/Pnesidcnt
2200 Ritchey Street
Santa Ana, CA 92705
Re: Further Extension of Agreement A-2021-068-08
Dear Ms. Davis:
CITY MANAGER
Kristine Ridge
CITY ATTORNEY
Soria R. Carvalho
CLERK OF THE COUNCIL
A-2021-068-08B
Pursuant to Agreement A-2021-06M8, entered by Habitat for Humanity of Orange County, Inc. and the City of
Santa Ana, dated July 6, 2021, Section I.B., Amount of Grant/Term and Monthly Disbursement, the time period pf-
said Agreement is hereby further extended for an additional two (2) months, through F41arvalifl,4000023. All other
terms and conditions of said Agreement remain unchanged and in full force and effect.
If you have any questions, please contact David Flores, Community Development Analyst with the Community
Development Agency at 714.647-6561.
Sincerely, _
Michael L. Garcia '
Executive Director,
Community Development Agency
C Y OF SANTA A
Kristine Ridge
City Manager
APPROVED AS TO FORM:
Sonia R. Carvalho
City Attorney
Btandon Salvatierra
Deputy City Attorney
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HABITAT I' 1MANITY OF OC,1NC.
Monique avis
CEO/Pros ent
ATTEST:
om_ta Orozco
Acting Clerk of the Council
SANTA ANA CITY COUNCIL
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